DefinitionThis section has been translated automatically.
Simultaneous intake of 5 or more prescription or non-prescription drugs. Polypharmacy is often associated with multimorbidity. It is facilitated by inaccurate indications, inadequate medication planning and insufficient consultation between the parties involved: patients/relatives/physicians/pharmacists. The frequency of polypharmacy is increasing worldwide, even in emerging and developing countries. This is partly due to increasing life expectancy and partly due to the increasing number of people who have access to medicines.
Another definition of polypharmacy is: the prescription of more drugs than clinically indicated and/or a regimen with at least one unnecessary drug.
Occurrence/EpidemiologyThis section has been translated automatically.
According to a survey conducted by a health insurance company (Barmer) in 2016, almost 12.5% of all insured persons were prescribed 5 or more active ingredients over at least one quarter and therefore fulfilled the criterion of polypharmacy. Over 3 quarters, this applied to 5% of all insured persons. Around 36% of all over 65-year-olds receiving medication are "cumulative polypharmacy", defined as a prescription of 5 or more active ingredients within one quarter. The proportion of older patients who do not follow doctors' orders for pharmacotherapy is around 20-50%.
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DiagnosticsThis section has been translated automatically.
Inventory of medication intake and medication assessment: checking the appropriateness of prescriptions.
TherapyThis section has been translated automatically.
Optimizing the medication process: In order to optimize and ensure the safety and quality of drug therapy, the entire prescription process should be considered, with the following steps that are run through cyclically:
Inventory: medical history including medication history
Medication assessment: critical review and evaluation of medication
Consultation with the person being treated about their needs and ideas on drug therapy
Prescription suggestion: therapy modification, discontinuation attempts, etc.
Communication: informing the patient/relatives
Monitoring (examination of treatment results, recording of adverse drug reactions - ADRs).
LiteratureThis section has been translated automatically.
- Lohnstein M, Eras J, Hammerbacher C. Der Prüfungsguide Allgemeinmedizin - 4th edition. Augsburg: Wißner-Verlag, 2022.
- German Society for General Practice and Family Medicine (DEGAM). S3 guideline for general practitioners: Multimedication. AWMF guideline no. 053-043, status 2021.
- German Society for General Practice and Family Medicine (DEGAM). S3 guideline Multimorbidity - Living Guideline. AWMF guideline no. 053-047, status 2023. register.awmf.org
- Heim TM (2022) Drug therapy in old age - a challenge. Med Monatsschr Pharm 45: 306-11.
- National Association of Statutory Health Insurance Physicians (KBV). Medication plan. Berlin 2023. www.kbv.de
- Köberlein-Neu J et al. (2016) Interprofessional medication management in multimorbid patients - A cluster-randomized study (WestGem study). Dtsch Arztebl Int 113:741-748.
- Thürmann P (2016) Drug therapy safety - models of interprofessional collaboration. Dtsch Arztebl Int 113: 739-40.
- German Society of Internal Medicine (DGIM). S2k Guideline Drug Therapy in Multimorbidity - Living Guideline. AWMF guideline no. 100-001. 2023 version.
- Dörks M et al. (2015) Polypharmacy, impaired renal function and adapted medication in nursing home residents - results of the IMREN study. German Medical Science GMS Publishing House
- Musini VM et al. (2019) Pharmacotherapy for hypertension in adults 60 years or older. Cochrane Database Syst Rev 6: CD000028.
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